NHS Barking and Dagenham Enhanced Sexual Health Service and Detailed Specification

The objectives of this service

  • To increase the level of protected (safe sex) in sexually active under 25 year olds
  • To eradicate Chlamydia infections in infected under 25 year olds
  • To increase the level of effective regular contraception for all females wishing to avoid conception
  • To widen the prompt access to Emergency Hormonal Contraception
  • To expand the c card system appropriately and to limit potential fraud

Why Barking and Dagenham needs this service

  • We have the highest rate of teenage pregnancies in London
  • Recently in one class of twenty 15-16 year olds, seven were pregnant
  • We have one of the highest rates of abortions in the country
  • This causes a significant financial burden to local NHS resources and potential psychological and clinical damage to the individual

Therefore

  • All sexual health consultations to be confidential and respectful.
  • Every c card registration MUSTinclude a demonstration of how to use a condom
  • All C cards applicants (13 to under25 year olds) to be requested for some form of identity check (e.g. bus pass) and full post code. Inform applicants that excessive requests will be followed up. Requests for more than 6 condoms a week to be referred to a Family Planning Clinic
  • All c card applicants (16year olds to under 24year olds) to be offered a Chlamydia Screen
  • The risk of Chlamydia infection rises with the number of sexual partners.
  • It takes at least 3 weeks in the infected individual for the infection to show in the urine.
  • The Chlamydia Screening Scheme recommend retesting annually
  • Female C card applicants to be given Family Planning (FP) advice
  • Further supplies of condoms to include the need for a Chlamydia screen and for females FP advice
  • There is no upper age restriction for the supply of EHC but the service is only to be promoted for under 25 year olds
  • Supply of EHC to over 25 year olds is simpler and carries a fee of only £15 inclusive of the drug cost
  • The EHC is to be self administered on site, unless there is a valid reason for delay. Delaying to take the dose with food is not a valid reason
  • All EHC clients to offered FP advice and if applicable a Chlamydia screen (this may have to be delayed)
  • The pharmacy must have the YPF promotional material prominently displayed
  • All frontline staff to be aware of the service
  • It is envisaged that frontline staff will be involved with Chlamydia screening, condom registration and further supply. These staff must be trained and deemed competent by the provider
  • The quality of the service to be provided to be assessed by the use of mystery shoppers

Payment per activity (agreed with the LPC)

  • C card Registration- £10 per registration
  • Further supplies of condoms- £1 per supply
  • Completed Chlamydia Test posted to lab - £8 per posted test. The following monthly bonus system applies on reaching 10 in a single month £20 on reaching 20 £50 in total and on reaching 30 £100. To qualify for the bonus this must be claimed for by the 10th day of the following month.
  • EHC consultation for 13 to under 25 year oldsincluding safe sex, need for Chlamydia screening and contraception advice £25 per consultation
  • EHC consultation for over 25 year olds, which is not to be openly promoted £15

Activity details MUST be submitted per 10th day of the following month for payment

  • On the proforma invoices provided
  • This eventually will be handled electronically by Adastra

Annual fee of £200 per pharmacy

Can be invoiced after the following has been completed

  • A successful second Young People Friendly Service Audit utilising a mystery shopper to confirm that all frontline staff are aware of the service and there is always a trained person to demonstrate correct use of a condom.
  • A declaration by the pharmacists utilising the EHC PGD that they have completed the CPPE Emergency Hormonal Contraception Module and have read and comprehended the EHC PGD .Please fax the CPPE certificate and declaration to Claudette Anderson on 0208 532 6339
  • Some activity in c card registration and Chlamydia testing over a 3 month period.

Right to claw back

  • If during the 12 months , the pharmacy is inadequately providing all the services then NHS Barking and Dagenham has the right to claw back the annual fee on a pro-rata basis- ie provision of only 6 months satisfactory service would require £100 payback.
  • Any unsatisfactory YPF inspection or server user complaint would be fed back to the contractor promptly to enable quick resolution and very low activity /inactivity will be discussed with the contractors and advice given, at least twice before a decision is made to cancel the service

Terms

  • As this is a new service, the terms will be formally reviewed after 3 months
  • It is envisaged that the condom and Chlamydia testing will be delivered by trained frontline staff.

Phillippa Crockford Nov 2010

Lead Sexual Health Clinical Pharmacist

NHS Barking and Dagenham